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Cardio Ass and Diag
Chapter 35
Question | Answer |
---|---|
Troponin | released into the bloodstream w injury to cardiac mus. Most specific and sensitive for MI- Any rise in value indicates cardiac necrosis or MI |
CK | CK-MB elevations occur with myocardial injury-Peak levels occur 24hrs after onset |
Myoglobin | earliest marker detected-2hours after MI with rapid decline after 7 hours |
Microalbuminuria | small amt of protein in urine indicate widespread endothelial disfunction in CVD |
PT/INR | PT-bleeding time-maintained with Coumadin therapyINR-most reliable way to monitor anticoagulant status |
PTT | assessed in pts who are recieving heparin |
Electrolytes | cardiac manifestations often occur when there is an imbalance of electolytes. K, NA, Mg, Ca |
RBC | increased in heart disease |
WBC | increased after MI |
Hematocrit/Hemoglobin | decreased indicate aggravate heart failure |
PA | posteroanterior and left lateral x-ray are routinely obt to determine the size, silhouette and position of heart |
Cardiac Cath shows what | includes studies of the right or left side of the heart and coronary artieries |
How to prepare a pt for cardiac cath | take pt vital signs, ausculate the heart and lungs, and assess the peripheral pulses. Question about iodine allergyLAB-BUN/Creatine,electolytes,PT, and CBC |
What post op proceedures for cardiac cath | Head of bed flat or 30 degrees (dep on dr)Monitor pt vitals every 15 min for 1st hrAssess for drainage/hematomia formationREPORT ANY SIGNS OF:pain, nausa, cardiac ischemia, neurologic changes, slurred speach ect. |
Electrocardiography (ECG) | routine part of every cardiovas. exam and one of most valuable diagnostic tests |
ECG monitors for what | cardiac dysrhythmias, myocardial ischemia, site/extent of MI, hypertrophy, electrolyte embalances and eff of cardiac drugs |
How to prepare a pt for Stress Test | comfortable shoeslight meal 2 hrs before but no smoking or ETOH |
Echocardiography measures what | noninvasive, risk free test, usuing ultrasound waves to assess cardiac structre and mobility, PARTICULARLY of the VALVES |
What is MNPI | Myocardial Nuclear Perfusion Imaging-radionuclide technique |
What are the two types of MNPI | TechnetiumThallium |
What does Technetium Scan Show | radioisotope accumulates in damaged myocardial tissue "HOT SPOT". Helps detect an acute MI and define its location and size, DOESNT show old infarction |
What does Thallium Scan Show | Necrotic or ischemic tissue doesnt take up radioisotope "COLD SPOT" Used to assess myocardial scarring and perfusion. Can detect acute or chronic MI |
MRI is | a noninvasive image of the heart or great vessels through radio waves and magnetic fields |
Before an MRI make sure a pt has | removed all metallic objects, jewlery, hair clips, clothing. PTs w/pacemakers or implanted defib should not ungergo MRI |
Some pt can experience ________in a MRI | claustrophobia |
Hemodynamic Monitoring is used where | in crital care settings |
Pt needs to be in ____position during cat insertion in Hemodynamic Monitoring | supine or trenddlenburg |
Increase RA pressure may show | Right Ventricular Failure |
Low RA pressures indicate | hypovolemia |
Normal PAP is | 15-26 systolic5-15 diastolic |
Elevated PAWP measurements indicate | left ventricular failurehypervolumiaMitral regurgitationor shunt |
Decrease PAWP meausrements indicate | hypovolemia |
CCRN obtains and recors RA pressure at intervals of | one to four hours |
Pt is normally ________ with the head of the bed elevated_____degrees | supine: 45 degrees |